Often, self-reported measures are used to assess whether sleep apnea treatment is working or not. For example, after treatment begins, patients are often asked how sleepy they feel or how many times they wake up during the night. These measurements, however, do not always align with how well sleep apnea is being treated. In other words, you may continue to rate yourself as sleepy even after the apneas are gone – so does this mean that the treatment is not really working? Not necessarily. If other “objective” measures indicate that bodily health is improving, it would be an indication that treatment is working, despite residual symptoms of sleepiness or awakenings. So which measurements could be used to assess bodily health?
Recently, it has been found that a protein called C-reactive Protein (or CRP) is higher in the body after sleep deprivation and in those with untreated sleep apnea. CRP is an important marker, as it indicates how much inflammation is in the body. And by the way, inflammation is a bad thing. So if poor sleep and sleep apnea increase inflammation and CRP, might effective sleep apnea treatment decrease CRP levels?
A group of scientists at Rush University investigated this question using an interesting treatment option – an oral mandibular device. These are small devices that are worn like a mouth guard. They pull the bottom jaw forward so that the airway is larger and thus less collapsible. These devices reduce apneas, but do they show an improvement in physiological health via a reduction in CRP?
Forty-nine patients with formerly diagnosed but untreated sleep apnea were included in the study. They were fitted with oral treatment devices, and CRP levels were measured. After 2-3 months of treatment, CRP levels were again measured and compared with before-treatment levels.
As expected, apneas were reduced and blood oxygen levels were partially restored with the use of the oral device. Perhaps not surprisingly, CRP levels were high prior to treatment and were significantly lowered following the brief period of treatment, indicating that sleep apnea treatment minimizes bodily inflammation.
This study makes a great case for sleep apnea treatment (in whichever form works for you), as it shows a reduction in the bodily injury that is caused by repeated apneas and hypopneas. Luckily, despite years of apneas, the body is able to restore itself following treatment. Treatment works!
Yalamanchali, S., Salapatas, A. M., Hwang, M. S., Pott, T. R., Lundgren, M. E., Joseph, N. J., & Friedman, M. (2014). Impact of mandibular advancement devices on C‐reactive protein levels in patients with obstructive sleep apnea. The Laryngoscope.